Provider Demographics
NPI:1265743215
Name:HOWARD, JOHN FRIERSON JR (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRIERSON
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 HENDRICKS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3305
Mailing Address - Country:US
Mailing Address - Phone:904-398-1247
Mailing Address - Fax:904-398-8647
Practice Address - Street 1:1925 HENDRICKS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3305
Practice Address - Country:US
Practice Address - Phone:904-398-1247
Practice Address - Fax:904-398-8647
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN190631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice